Current guidelines recommend discontinuing proton pump inhibitors (PPIs) before performing the urea breath test for H. pylori. A new test protocol reported in the January issue of the American Journal of Gastroenterology incorporates a test drink of citric acid, which reduces the false-postive rate so that discontinuing acid suppressive therapy is not necessary.
“The use of PPIs and of histamine H2-blockers may result in false negative results during diagnostic urea breath tests (UBT); therefore, cessation of PPIs and H2-blockers 7-14 days before UBT is currently recommended,” write Haim Shirin, MD, and colleagues from the E. Wolfson Medical Center in Holon, Israel. “However, for ‘PPI dependent’ patients this may be a critical issue, because PPI withdrawal is strongly associated with symptom recurrence.”
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